As the COVID-19 pandemic continues to impact so many aspects of daily life, we understand you likely have questions about the nature of this disease and its implications for your health and the health of those around you.
Below you’ll find answers to some of the most frequently asked questions surrounding COVID-19, SARS-CoV-2 (the novel coronavirus). Bear in mind that, as a new disease, our understanding of how it behaves and how it can be prevented or treated continues to evolve. We will continue to update this page with new information as it becomes available.
What exactly is COVID-19?
COVID-19 is a disease that affects humans when they become infected by a new strain of coronavirus, SARS-CoV-2, sometimes referred to as the new coronavirus or novel coronavirus. “COVID” is an abbreviation, shortened from “coronavirus disease.” A coronavirus is a member of a family of viruses that may circulate among humans, bats, camels, cattle, cats, and other animals. When infected, humans and animals may manifest a mild, moderate, or severe respiratory disease.
The “new coronavirus” linked to COVID-19 is officially known as SARS-CoV-2 (“Severe Acute Respiratory Syndrome Coronavirus 2’). It is the seventh coronavirus known to infect humans. Different coronavirus strains resulted in:
- The 2003 SARS outbreak that infected roughly 8,000 people and killed roughly 800
- Middle East Respiratory Syndrome (MERS), which emerged in Saudi Arabia in 2012, resulting in 2,500 confirmed cases and over 850 deaths.
SARS-CoV-2 was isolated and identified on January 7, 2020 by Chinese authorities after several mysterious cases of severe pneumonia broke out in the city of Wuhan, China (population 11 million) in late December 2019. Chinese authorities released the SARS-CoV-2 genome sequence for public scrutiny on January 10, 2020.
It is believed that the new coronavirus leapt from animals to humans at the Huanan Seafood wholesale market in Wuhan. At this market, both living and slaughtered animals, some of them wild land mammals, are traded in the open air.
Asymptomatic vs. Symptomatic COVID-19: When Are People Contagious? What are the Symptoms of COVID-19?
A person infected with SARS-CoV-2 may either be:
- Asymptomatic. A person is infected with the novel coronavirus, but symptoms of COVID-19 never develop.
- Presymptomatic. A person is infected with the novel coronavirus. Symptoms of COVID-19 have not yet manifested, but they will manifest within hours or days.
- Symptomatic. A person is infected with the novel coronavirus and exhibits symptoms of COVID-19.
Symptoms of COVID-19 include a dry cough, fever, body aches, chills, fatigue, headache, suppressed sense of smell and taste, and loss of appetite. People may also experience gastrointestinal illness and symptoms of pneumonia. These symptoms can range from mild to severe and even life-threatening if the lungs are compromised to the point of respiratory arrest.
According to Harvard, the presymptomatic period is thought to range between 3 and 14 days. However, presymptomatic individuals have been shown to spread the disease to other patients at least 48-72 hours prior to the onset of symptoms. This is believed to apply to asymptomatic individuals as well.
This means that a person may have no symptoms of COVID-19—may not even be aware of their SARS-CoV-2 positive status—and still spread the virus to others who go on to have symptomatic and even severe cases.
Individuals with COVID-19 are thought to be contagious up to 10 days after symptoms resolve.
How Does COVID-19 Spread?
COVID-19 is spread by humans transmitting SARS-CoV-2 from the lungs of one infected host to another. Humans can become infected with SARS-CoV-2, the coronavirus that causes COVID-19, by breathing in droplets of moisture that were released from an infected person’s breath.
This moisture can be generated through coughing, sneezing, or exhaling. If infected persons cough into their hand or touch their mouth, nose, or eyes, droplets of infected moisture may transfer to the hand, where they can then be transferred to any surface the infected person touches.
SARS-CoV-2 has been shown to survive on hard or cloth surfaces for several hours at least and sometimes for days. It is killed by almost any disinfectant, including foaming soaps and detergents.
FAQ: Can pets transmit or contract COVID-19?
According to Tufts and the CDC, there have been a small number of household pets like cats and dogs that have been infected with SARS-CoV-2, mostly after contact of people with COVID-19. Only a few of these pets showed signs of illness.
However, the risk of it transmitting from animals to their pet parents are considered low and CDC currently states there is no evidence of pets playing a significant role in the spread of COVID-19. At this point, CDC recommends keeping pets away from people or animals that are outside of the home. If someone becomes sick in your house, keep pets away from the quarantined family member.
Please consult with your veterinarian if your pet becomes sick, but please do not take your pet to the veterinarian if you are sick, with COVID-19 or any other communicable illness.
FAQ: Do Masks Protect You From COVID-19?
SARS-CoV-2 has exhibited an ability to spread rapidly when people have face-to-face interactions without personal protective equipment (PPE) like medical masks, gloves, and face shields. Asymptomatic or presymptomatic individuals have been shown to be capable of infecting as many as 1,000 people in a single day if they came into physical contact with large crowds throughout the day.
Masks prevent aspirated droplets from the person’s respiratory system from disbursing into the environment and protecting others. Basic masks - like those that are handmade from fabric - do not protect the wearer from inhaling infected droplets and becoming infected themselves. Masks are for protecting other people, not the mask-wearer.
Self-Isolation, Quarantine and Social Distancing - Why are so many people staying home?
Some people are staying at home due to orders to "stay home" or “shelter in place,” or as part of an imposed or suggested quarantine. A quarantine is a method of stopping or slowing the spread of a disease by isolating an infected person from other people during the period when they are suspected or known to be contagious. A person may be quarantined in their home, temporary residence, or a hospital or other specialized quarantine facility.
Quarantines may be imposed by governments, but people who suspect they have been exposed or become infected might choose to “self-quarantine.” Nobody is making them avoid contact with others, but they choose to do so out of personal responsibility to avoid infecting others. After all, infected persons can spread the disease even if they don’t display symptoms.
Governments might impose stay-at-home orders or a quarantine to control the spread of a disease during:
- Outbreaks. A sudden increase in the rate of infection.
- Epidemics. Similar to outbreaks but more widespread.
- Pandemics. A larger epidemic, sometimes of global proportions. The World Health Organization (WHO) declared COVID-19 a global pandemic on March 11, 2020.
Instead of self-quarantining, asymptomatic individuals might leave isolation but take protective measures like wearing masks and/or practicing social distancing.
Stay-at-home orders may be imposed to try and control the rate of transmission (RT). RT measures how many other people an infected person may spread the virus to before their period of contagion ends. If RT in a population is 1, every infected person will infect an average of one other person. If RT is 2, that infected person will transmit the virus to an average of 2 other people. If RT is above 1 in a population, the disease is accelerating throughout the population. If RT is below 1, the spread of the disease is slowing down.
Governments may also choose to impose a quarantine on foreign visitors arriving at their borders. Governmental pandemic policies are tailored to their populations. Allowing foreign infected cases to mingle with those populations eliminates the government’s ability to monitor, track, and recalibrate the laws and policies it may impose to try and control the virus.
What Is “Social Distancing” and Why Are So Many People Doing It?
Social distancing helps protect individuals from becoming infected. Respiratory moisture containing the virus has shown little or no ability to travel more than 6 feet (1.5 meters) away from the mouth and nose when aspirated; instead, the virus falls to the ground and becomes inert within hours.
By maintaining a distance of 6 feet (1.5 meters) from other individuals, people can be reasonably certain that they won’t contract SARS-CoV-2 from someone who is infected or give it if they are infected themselves. However, SARS-CoV-2 can live for hours on surfaces like countertops and doorknobs, even if the person who left the moisture there is long gone.
How Long Should a Person with COVID-19 Isolate?
The best-accepted incubation and recovery period for SARS-CoV-2 is 10-14 days. Whether the person has tested positive for SARS-CoV-2, exhibited symptoms, or neither, it can generally be assumed that after 14 days of quarantine, that person is not contagious and may leave quarantine without infecting others. It does not, however, prevent that person from becoming infected after leaving quarantine, especially if the subject never had the virus in the first place.
Can A Person with COVID-19 Be Re-Infected?
Whether or not a person who has been infected by the novel coronavirus in the past can become infected again is not fully known. Isolated cases of reinfection have been reported, but not widespread enough to draw conclusions.
From our current understanding of virology, people often become immune or at least resistant to reinfection from a virus after the body recovers from that virus. How immune or resistant the body becomes to SARS-CoV-2 is, as of yet, unknown. If the virus mutates, reinfection by a mutated strain becomes far more likely. There is some evidence that the virus has already mutated once, but other studies indicate that it mutates far more slowly than the seasonal flu, which requires a new immunization every year, or HIV, which mutates so rapidly that an HIV vaccine is effectively impossible under current medical science.
Why Should I Get Tested for COVID-19? When Should I Get Tested?
The CDC has issued guidelines of when and why you should undergo testing for COVID-19. These include:
- If you have been exposed to a person who has tested positive for a SARS-CoV-19 viral load within the last 14 days.
- If you exhibit symptoms that correlate with COVID-19, like a fever, dry cough, fatigue, etc.
- Especially consider testing if you are in a demographic known to be susceptible to severe and even fatal cases of COVID-19 (over 60, comorbid conditions like diabetes, heart disease, respiratory disease, or a compromised immune system).
Molecular RNA testing - found in nasal swab PCR testing - is now more widely available now than it was at the start of the epidemic. Early on, people with symptoms were discouraged from seeking testing and encouraged to weather the symptoms at home unless they became severe, at which point hospitalization would be appropriate.
In addition to molecular testing for the presence of the virus, antibody testing is now more widely available, with FDA-approved tests yielding 98%+ accurate results. A person may consider getting an antibody test if they exhibited COVID-19 symptoms in the past, or if more than 14 days ago they were exposed to a person known to be SARS-CoV-2 positive.
This test tells you if you have been infected with SARS-CoV-2 in the past. However, antibodies can take up to 6 days to manifest, so asymptomatic patients may require two or more tests, spaced out over a week or more, before the antibody test produces a positive result.
The difference between RNA and antibody tests are explained more thoroughly in the next section.
What are the different methods for testing for COVID-19?
There are two major categories of tests that apply to COVID-19 and SARS-CoV-2—molecular testing and antibody testing.
COVID-19 Testing: Molecular RNA Testing
Molecular tests examine samples and specimens for certain proteins, genes, or other molecules associated with a particular genomic profile—in this case, the genomic profile of SARS-CoV-2. A positive SARS-CoV-2 molecular test indicates that the novel coronavirus is present in the subject’s sample tissue at the time of testing. A negative test means that no SARS-CoV-2 is detected. This does not mean that the patient won’t become infected the day after the test, or even the hour after the test. It just means that no SARS-CoV-2 is detected in the sample harvested at the time of testing.
More than 30 companies have been authorized by the FDA to distribute molecular tests to hospitals and clinics, with over 100 more having submitted claims of internally-validated molecular tests to the FDA for approval.
These tests deploy a molecular analysis method called reverse transcription polymerase chain reaction (RT-PCR). Lab technicians copy/replicate the genetic information gleaned from the sample, then compare it to the known genetic profile of SARS-CoV-2.
In-clinic tests that have been approved by the FDA gather samples from the patient in one of two ways:
- Nasal Swab. A 6-inch-long swab is inserted deep into the nasal passages of the subject to gather fluid that has been in the respiratory system. This collection method is more invasive and causes more discomfort than other methods.
- Saliva. Rutgers’ RUCDR Infinite Biologics recently received FDA approval for the first SARS-CoV-2 molecular test that could produce equally accurate results from a saliva sample. Not only is this collection method more comfortable, it also does not require a disposable swab, supplies of which may at times be low.
On April 20, 2020 the FDA authorized the first home-sample-collection molecular test for SARS-CoV-2, known as Pixel and produced by LabCorp. The Pixel test is mailed to the recipient and contains a swab that need only scrape the insides of the nostrils, rather than requiring insertion up into the deep nasal passages. The sample is then sealed in an included receptacle and mailed back to LabCorp for analysis.
COVID-19 Testing: Antibody Testing
Whereas molecular testing may detect the presence of a SARS-CoV-2 infection in progress, antibody testing reveals whether or not a test subject has been infected with SARS-CoV-2 in the past, regardless of whether they exhibited symptoms of COVID-19. This is also known as a serology test, due to the fact that a patient’s blood serum must be examined in a lab to detect the antibodies.
Antibodies are proteins that the body produces in the process of fighting off an infection. It can take several days or weeks for certain antibodies to appear in the blood. For example:
- Immunoglobulin M (IgM) is an antibody produced early in an infection before receding rapidly. The presence of IgM in a serology test indicates a recent infection.
- Immunoglobulin G (IgG) has a much longer half-life in the blood than IgM. The presence of IgG without the presence of IgM indicates an infection that may have happened a significant time ago.
- Immunoglobulin A (IgA) is a third antibody lab techs look for to deduce a prior SARS-CoV-2 infection. IgA indicates immune system activity in the mucous membranes.
Serology tests produce fast results thanks to a technique called ELISA (enzyme-linked immunological assay), most notably used to detect HIV antibodies.
SARS-CoV-2 serology tests are important for two reasons. First, they may help scientists accurately determine how infectious the new coronavirus is by exposing asymptomatic and mildly symptomatic cases that went undiagnosed during the contagion window. Secondly, many immune responses to viral infection render the body effectively immune to reinfection. Persons who have been infected by SARS-CoV-2 in the past may no longer be susceptible to COVID-19 and may in fact no longer be a vector for the spread of the virus. A large-enough SARS-CoV-2 seropositive demographic may even confer herd immunity upon a population, slowing the spread to almost nothing.
However, a seropositive patient’s immunity to reinfection by SARS-CoV-2 is not proven and still in dispute. The novel coronavirus may be subject to mutation, and a seropositive patient may not be immune to the mutated form of the virus.
How Do You Order a COVID-19 Test Online?
We currently provide a home-based SARS-CoV-2 test on our website. Our test is a PCR swab-based test designed to identify an active SARS-CoV-2 infection. The imaware™ Respiratory Coronavirus Test may be right for you if:
- You are currently experiencing COVID-19 symptoms.
- You live in or recently traveled to an area with an ongoing spread of COVID-19.
- You have been in close contact with a person known to have COVID-19.
- You think you have been exposed to COVID-19
To find more information and better understand your suitability, take our 5 minute online risk assessment.
Is There a Treatment for COVID-19?
According to Harvard most cases of COVID-19 do not require hospitalization. Patients are advised to quarantine at home for at least 14 days and treat their symptoms with over-the-counter cough suppressants, anti-inflammatory medications, fluids, and bed rest. Patients should also maintain meticulous hygiene to avoid spreading the disease and wear a mask if they must go out in public.
No vaccine currently exists to prevent SARS-CoV-2 infection, nor have any mitigating treatments enjoyed widespread successful, double-blind testing that would cement their legitimacy. However, active tests of many treatments are underway, some with promising anecdotal results.
Drugs currently being tested to treat severe COVID-19 cases include established antimalarial medications, established antiviral medications, and antibodies found in the blood plasma of people who have recovered from COVID-19. Turning patients on their stomachs instead of their backs has also correlated with an alleviation of respiratory symptoms.
When the most severe cases of COVID-19 lead to respiratory arrest, the patient may be kept alive with a breathing tube attached to a mechanical ventilator, but prognosis for recovery from this state is considered 50/50 at best.
COVID-19 and Pneumonia: How do they relate?
Pneumonia describes several types of severe lung infection, either from virus or bacteria, that can cause difficulty breathing and may result in insufficient oxygen reaching vital organs like the brain, heart, and digestive system. Pneumonia may be fatal in older people or people with pre-existing respiratory disease.
Symptoms of pneumonia include coughing, shortness of breath, loss of appetite, fever, nausea, and vomiting. Pneumonia is a symptom associated with COVID-19. In fact, early cases of COVID-19 in Wuhan, China were classified as pneumonia of unknown origin. Some patients with COVID-19 with severe disease may even require hospitalization for management of their pneumonia.
COVID-19 and Diet: What you should be eating to support your immune system?
The immune system’s response to COVID-19 is still not well understood. While scientists can point to several comorbid conditions and correlations, it isn’t entirely clear why one person might become deathly ill from COVID-19 and another person might never develop symptoms at all.
However, a healthy immune system can help you be better prepared to fight off infection. While no diet has been shown to be effective against COVID-19, people concerned with their health during the pandemic can consider tailoring their diet for maximum immune system health. Those with pre-existing conditions, that might be at more risk for disease, need to manage their underlying condition to the best of their ability at this time.
Vitamin C is a well-known immune system supporter, correlated with an increase in disease-fighting white blood cells. Foods high in vitamin C include:
- Citrus fruits like oranges, tangerines, and grapefruit.
- Kiwi fruit.
- Sweet red pepper.
Beta-carotene is another powerful immune system supporter. The body converts it into vitamin A, a nutrient known for its anti-inflammatory and virus-fighting properties. Foods rich in beta-carotene include:
- Sweet potatoes.
The fat-soluble nutrient vitamin E is also known to support the immune system. You can find vitamin E in:
- Nuts and seeds.
Green tea contains immune-supporting antioxidants, as well as amino acids that may be linked to increased T-cell counts.
Vitamin D is also crucial to the regulation of the immune system. Your body creates vitamin D when it is exposed to sunshine, however you can also receive Vitamin D from foods. Foods rich in vitamin D include:
- Salmon and tuna.
- Egg yolks.
Vitamin B-6 helps the body make new red blood cells and helps regulate the lymphatic system, which helps distribute white blood cells throughout the body where they can fight infections. Foods rich in vitamin B-6 include:
- Salmon and tuna.
- Turkey and chicken.
- Chickpeas and hummus.
- Fortified breakfast cereals.
Water also helps produce lymph fluid. In addition to drinking water and tea, foods like celery, cucumbers, and watermelon have high water content.
Finally, immune cells require the metal zinc to function properly. Zinc is not naturally produced by the body, so it must be ingested from foods like:
- Shellfish, including crab, lobster, clams, and mussels.
- Poultry, like chicken and turkey.
- Red meat.
- Some fortified cereals and breads.
FAQ: Does Vitamin D play a role in the prevention of COVID-19?
Global data on COVID-19 has revealed a correlation between COVID-19 fatalities and vitamin D deficiency. Northwestern University analyzed data from some of the countries hardest hit by COVID-19, including China, France, Germany, Italy, Iran, South Korea, Spain, Switzerland, the United Kingdom (UK) and the United States. The statistical analysis revealed higher COVID-19 mortality in countries that experienced widespread vitamin D deficiency, like Italy, Spain, and the UK.
Some experts speculate that COVID-19 might not be the direct cause of death itself. The culprit may be a comorbid condition called a cytokine storm, an autoimmune reaction triggered by a lung infection like COVID-19, which causes the immune system to attack the lungs themselves, causing potentially fatal respiratory arrest. Cytokine storms have been known to correlate with vitamin D deficiency since before the COVID-19 pandemic.
However, no evidence currently indicates that vitamin D supplements might reduce the likelihood of an individual patient to die from complications due to COVID-19.
FAQ: Celiac and COVID-19: Is there a connection?
Celiac disease is an autoimmune condition that arises from the affected individual’s inability to absorb gluten, a protein found in many food products. Autoimmune conditions like lupus, AIDS, and Type II diabetes are widely recognized to be key comorbid conditions for COVID-19, resulting in a much higher likelihood of death from an infection by SARS-CoV-2. Because celiac disease is an autoimmune disorder, patients may worry that they are at a higher risk of death from COVID-19 than people who can tolerate gluten.
However, according to the National Celiac Association (NCA), while the immune system is involved in the expression of celiac disease, most doctors do not consider celiac patients to be immunocompromised. There is currently no evidence that patients with celiac disease have a substantially higher COVID-19 mortality rate than patients who do not have celiac disease.
Information about the correlation between celiac disease and COVID-19 mortality is still evolving, like most information around COVID-19. Celiac disease patients should keep a close eye on new statistics as they emerge.
While unable to confirm comorbidity of celiac disease and COVID-19, the Celiac Disease Center at Columbia University Medical Center has reported worse outcomes for celiac patients infected by other diseases, including influenza and pneumococcal pneumonia.
What's Next in COVID-19 Testing?
We are proud to have administered many home-based respiratory coronavirus tests throughout the city of Houston, as well as on-site with our partners at RigUp. As a valuable leader in at-home testing, we are working on launching coronavirus tests, (like an antibody test) that can be performed in the comfort of your own home or place of business.
We will be updating this article to include any new information about SARS-CoV-2, respiratory coronaviruses, and COVID-19.